Sleep Disorders: Restless legs and other movement disorders during sleep
Restless, tingling legs force those affected to get up at night and walk around. In contrast, periodic leg movements during sleep often interrupt the night’s sleep unnoticed
Restless legs – syndrome of restless legs
Missing legs can not sleep between five and ten percent of the population for a limited or longer period in their lives. Tingling and pulling in the calves often causes problems during the day. Older people complain about it more often, but also younger people. Especially pregnant women occasionally suffer from restless legs.
In addition, fluctuating temperatures, alcohol abuse , smoking and the side effects of certain medications, such as antidepressants, may play a triggering role.
Restless Legs Syndrome can also be associated with diabetes, iron deficiency, bowel disease, multiple sclerosis, or depression. Often there is a family predisposition, especially in people who are more severely affected by the disorder.
Medical researchers assume that faulty nerve impulses trigger the symptoms. Restless legs syndrome is often associated with periodic nocturnal leg movements (see below).
Symptoms : unpleasant tingling, “pins and needles”, drawing pains mainly set in the calf muscles in a quiet posture one , especially in the evening before going to sleep. By moving the legs and moving around, the symptoms are usually mild. The associated urge to move not only makes it difficult to fall asleep, but also forces those affected to get up at night. The deep sleep percentage is shortened or sometimes completely eliminated. Significant daytime tiredness , concentration and performance disorders are the result.
The tingling and stinging can significantly affect day-to-day life. It is then difficult to sit quietly longer, such as when driving a car, in professional meetings, in the cinema or on other occasions.
Diagnosis : Medical history and symptoms usually give the physician essential information for the diagnosis of a restless leg syndrome. To exclude other diseases, followed by physical examinations and blood tests, which also show certain iron levels (especially ferritin). In addition, a test with L-Dopa, a Parkinson’s drug, may provide information. If nerve damage is suspected, neurological examinations may also be indicated. Sometimes the doctor will consider a review in a sleep laboratory (see also chapter “Diagnosis” ).
Therapy : Easier, temporary ailments can often be contained with general measures. These include sports activities as well as the renunciation of alcohol and caffeinated drinks. Existing diseases and disorders, such as iron deficiency and anemia , the doctor will specifically treat. Increased, persistent symptoms are usually medications used, especially preparations that are actually intended for Parkinson’s disease , such as dopaminergics and dopamine agonists. Another option is the oxycodone / naloxone combination.
Further information on the clinical picture, diagnosis and therapy can be found in the guide “Restless Legs Syndrome (RLS, restless legs)”.
Periodic limb movements during sleep
It is primarily the legs, more rarely the arms, that are active at night, without the sleeper consciously perceiving the activities of his extremities. However, the quality of sleep suffers greatly, deeper sleep phases are disturbed. Especially older people over 60 have to do with it, many at the same time also with sleep apnea and narcolepsy (for the latter see chapter “narcolepsy, parasomnias” ).
The causes are not yet clear. As with restless legs, there is apparently a hereditary condition. Likewise, certain medications such as antidepressants, smoking , alcohol, caffeine, mineral deficiencies or physical and emotional stress are sometimes considered as triggering factors. The symptoms may also be related to kidney or metabolic diseases, which often result in poorer blood flow to the legs.
Delinquencies are the periodic movement disorders of harmless muscle twitching, which many people experience before falling asleep, but after a short while and do not affect sleep further.
Symptoms : The leg muscles, sometimes the arms, start to twitch (periodically) at regular intervals. The muscle twitch stops for a few seconds and occurs frequently in the first half of the night. Sufferers seldom realize it, but wake up briefly without realizing it. The so constantly interrupted sleep has increased daytime sleepiness with sometimes veritable sleep attacks.
Diagnose: Häufig sind es die Bettpartner, die von den manchmal heftigen Bewegungen gestört werden und entsprechende Angaben machen können. Der Arzt befragt den Betroffenen zunächst eingehend und untersucht ihn körperlich, um mögliche, noch nicht bekannte Begleiterkrankungen feststellen zu können. Für eine endgültige Diagnose der periodischen Bewegungen kann der Arzt mitunter eine Untersuchung in einem Schlaflabor erwägen. Dort wird aufgezeichnet, wie häufig nachts Muskelzuckungen auftreten und in welcher Form sie den Schlaf stören.
Therapy : The treatment depends on what a sufferer has due to the nocturnal movement disorder. Many do not feel significantly affected and do not need special treatment. Basically helpful are a healthy lifestyle and a behavior that benefits sleep. If, for example, nocturnal respiratory distress syndrome occurs, the leg activity often involves the treatment of sleep apnea by nasal positive pressure ventilation (see chapter “Snoring, sleep apnea” ).
Similarly, the complaints usually go back when an existing underlying disease is treated consistently. If the leg movements persist persistently and if the daytime tiredness is particularly pronounced, medications such as remedies for Parkinson’s disease can sometimes help.